Various surgical procedures are routinely carried out intravascularly or intraluminally. For example, in the treatment of vascular disease, such as arteriosclerosis, it is a common practice to access the artery and insert an instrument (e.g., a balloon or other type of catheter) to carry out a procedure within the artery. Such procedures usually involve the percutaneous puncture of the artery so that an insertion sheath may be placed in the artery and thereafter instruments (e.g., catheters) may pass through the sheath to an operative position within the artery. Challenges exist related to locating the artery prior to inserting a needle or other device used to create the percutaneous puncture and access the artery. Typically, the artery is positioned below a layer of tissue at an unknown distance from an outer surface of the patient. Further, the shape and size of the artery and an orientation of the artery may vary at different locations on a patient. Additionally, the operator may wish to insert the needle or other device being used to create the percutaneous puncture at a certain angle relative to a longitudinal axis of the artery or at a specific location around a circumference of the artery. Some or all of these considerations may create a need for improved systems and methods for locating and accessing vessels percutaneously.